Individual
JOHN PATRICK HALTOM
Active
Individual
JOHN PATRICK HALTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28266072A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001545969
ANTHEM PTAN
IN
01
—
000001615694
ANTHEM PTAN
IN
05
—
300051973
—
IN
Enumeration date
05/07/2021
Last updated
12/04/2024
Update your record
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